罗库溴铵用于剖宫产全麻诱导时效的观察与探讨

Observation and discussion on induction time of cesarean section under general anesthesia by rocuronium

目的比较罗库溴铵和维库溴铵用于剖宫产全麻诱导的起效时间及插管条件。方法择期全麻插管下行剖宫产手术患者64例,随机平均分为罗库溴铵组(Ⅰ组)和维库溴铵组(Ⅱ组),n=32。静脉给予依托咪酯0.15 mg/kg、氯胺酮1 mg/kg麻醉诱导,待患者意识消失后用4个成串刺激(TOF)来判断肌松效应,麻醉前T1(TOF第一个肌颤搐)作为判断肌松效应的指标,T1稳定(100%)后10 s内静推罗库溴铵0.6 mg/kg,维库溴铵0.1 mg/kg,T1为0%时完成气管插管,记录肌松药起效时间(推药后T1由100%到0),并评估插管条件。结果Ⅰ组、Ⅱ组的起效时间分别为(1.44±0.59)min、(3.69±0.85)min,差异有统计学意义,P<0.01;两组患者声门暴露和插管条件评级差异无统计学意义(P>0.05)。结论罗库溴铵起效迅速,诱导平稳,是剖宫产全麻诱导的理想用药。

Objective To compare the interaction between rocuronium and vecuronium bromide during induction of general anesthesia for cesarean delivery of working time and intubation conditions.Methods Patients undergoing elective surgery under general anesthesia intubation of cesarean delivery of 64 cases were randomly divided into the interaction between rocuronium group（ group Ⅰ） and vecuronium bromide group（ group Ⅱ）,n = 32. Vein gives etomidate 0. 15 mg / kg,1 mg / kg of ketamine anesthesia induction,treat patients consciousness disappears with four string stimulation（ TOF） to judge the muscle relaxant effect,anesthesia before T1 first muscle twitch（ TOF） as a judge index of muscle relaxant effect,stable T1（ 100%）after 10 seconds static push the interaction between rocuronium 0. 6 mg / kg,vecuronium bromide 0. 1 mg / kg,T1 was 0% complete tracheal intubation,record the muscle relaxant effect time（ T1 by 100% after the drug was pushed to zero）,and evaluate the intubation conditions. Results Group I,group Ⅱ work time respectively（ 73. 11 ± 16）,（ 216. 23 ± 35） S,the difference was statistically significant,P〈0. 01; Differences in two groups of patients the glottis exposure and intubation condition rating had no statistical significance（ P〈0. 05）.Conclusions The interaction of rocuronium effects quickly and has smooth induction,is an ideal drug for cesarean anesthesia induction.